We Drink More Than Don Draper But We Die Less Often

Matthew Herper
,
Forbes Staff
I cover science and medicine, and believe this is biology's century.

The fashion time-warp that is Mad Men will return to AMC on Sunday night. Worth pondering: the changes to the way we live, are cared for, and die have been as big as any cultural changes separating Don Draper and Joan Holloway from us.

Joan Holloway (Photo credit: Wikipedia)

Consider this: in 1965, Medicare was brand new. The death rate from heart disease was triple what it is today. Forty-two percent of adults smoked, double the percentage today. Only a third as many people were obese -- maybe people were really that much prettier back then. On the flip side, America's spending on health costs has gone from $26 billion to $2.6 trillion.

I was spurred to think about these differences because of the Advisory Board Company, which created a wonderful infographic that I've included below. Some of those stats are counterintuitive -- for instance, people in the 1960s don't seem to have consumed more alcohol on a per capita basis than we do now. Apparently, it was the 1970s that were the peak of booziness in America.

One of the biggest changes is the decline in smoking, which has been a plot point on Mad Men. The American Cancer Society's public service announcements in the 1960s really did dramatically change health for the better.

It's also staggering to think of how much better our treatments for so many diseases were. Heart attacks were generally lethal and unpreventable in the 1960s. Now a patient who has one, if they get to the hospital on time, can have the blockage removed with a catheter. The 1960s were when the Food and Drug Administration, in the wake of the thalidomide scandal, started requiring proof of efficacy and long-term safety, and when medicine started relying on clinical trials that compared new treatments to old ones or to inert sugar pills. Proving that medicines actually work has meant better medicines.

Courtesy The Advisory Board Company

This was really the dawn of modern drug discovery, when Leo Sternbach at Roche was inventing Valium and the other benzodiazapines for anxiety and when Maurice Hilleman, the Merck vaccine researcher, was creating most of the vaccines that would do away with diseases like measles, mumps, chickenpox, which causes cancer. The childhood diseases faced by Don and Betty Draper's kids are mostly thing of the past.

In heart disease, that means a whole armament of blood pressure pills and cholesterol-lowering medicines. In cancer, the differences are even more dramatic. In the 1970s more and more chemotherapy drugs were developed, and cancer treatment continues to improve. According to the Advisory Board, a cancer patient today has a 32% greater chance of surviving than one in Draper's time.

Our whole health care delivery system has changed, becoming increasingly funded by government with a huge role for private insurance. The battle over the creation of Medicare was every bit as pitched as the current fight over the Affordable Care Act -- the health care reform law also known as "ObamaCare." Ronald Reagan argued in 1961 that Medicare itself could potentially destroy democracy. You can hear that entire recording here.

Reagan said that "it is very easy to describe a medical program as a humanitarian project," and then warned that if people did not oppose Medicare, "one of these days you and I are going to spend our sunset years telling our children, and our children's children, what it once was like in America when men were free."

Don Draper of Mad Men works on Madison Avenue (Photo credit: Wikipedia)

Medicare still bears the scars of this battle. As a compromise, the program actually does much of what it does through subcontracting. But it still has become, for all intents and purposes, a national health insurance system for seniors -- a fact that is worth thinking about on the eve of arguments in front of the Supreme Court about whether the Affordable Care Act violates the Constitution. If there is one lesson to be taken from Mad Men, it's that the past influences the present in ways we would never expect.